Observation Of Clinical Treatment Of Macular Edema Secondary To Central Retinal Vein Occlusion By Intravitreal Ranibizumab And Laser Photocoagulation

Background: Central retinal vein occlusion is a common haemal disease which can lead to macular edema causing vision failing. As more and more modern people suffering from hypertension、atherosclerosis and other diseases, the incidence of central retinal vein occlusion had increased. Macula lutea is the most sensitive visual place in retina,causing great impact on vision when damaged,macular edema for example.Objective: To investigate the effectiveness of different ways for the treatment of macular edema caused by central retinal vein occlusion and to provide more basically effective method in clinic.Methods: This study included 66 eyes(30 male eyes,36 female eyes, 31 right eyes,35 left eyes, mean age was 55.78±15.84 years old)from 66 patients with macular edema caused by central retinal vein occlusion.These patients were are all diagnosed in the Ophthalomology department of The First Affiliated Hospital of Dalian Medical University from September 2012 to February 2015.All cases were divided into three groups: Group 1(27 eyes) received intravitreal ranibizumab(0.05ml/0.5mg) treatment only,at one mouth and at two mouth; Group 2(21 eyes)received laserphotocoagulation treatment only whinin two mouth; Group 3(18 eyes) received the same intravitreal ranibizumab protocol combined with laserphotocoagulation at one week after the first injection. Best corrected visualacuity and central macular thickness were evaluated before and after therapy. The date were analyzed with SPSS, A two-tailed P value of less than 0.05 was considered to be statistically significant.Results: In group 1, median BCVA(Log MAR) improved after 2 months’ treatment,from 0.74±0.12 to 0.40±0.11, result was statistically significant(P=0.001, P<0.05); median CMT decreased from(414.51±93.54)um to(254.73±84.65)um,result was statistically significant(P=0.001,P<0.05). In group 2, median BCVA(Log MAR) did not show significant difference after 2 months’ treatment,BCVA was from 0.72±0.10 to 0.63±0.09(P=0.25, P>0.05); median CMT decreased from(408.17±108.33)um to(378.61±132.21)um,did not show significant difference(P=0.24,P>0.05).In group 3,median BCVA(Log MAR) improved after 2 months’ treatment, result was significant,from 0.68±0.10 to 0.38±0.11(P=0.001, P<0.05); median CMT decreased from(418.45±89.21)um to(241.64±79.17)um,result was statistically significant(P=0.001,P<0.05). Group 2’s median BCVA(Log MAR) was lower than group 1 and group 3’s, result was statistically significant(P=0.02 and P=0.001,P<0.05); Group1 and Group 3’s median BCVA(Log MAR) was almost the same, did not show significant difference after 2 months’ treatment(P=0.58, P>0.05).Group 2’s central macular thickness was higher than group 1 and group 3’s, result was statistically significant(P=0.003 and 0.002, P<0.05); Group1 and Group 3’s central macular thickness was almost the same, did not show significant difference after 2 months’ treatment(P=0.53, P>0.05).Conclusions: 1.Intravitreal injection with ranibizumab is effective for macular edema caused by central retinal vein occlusion and median BCVA. 2.Laserphotocoagulation only have little treatment for macular edema caused by central retinal vein occlusion and median BCVA elevating compared to intravitreal injection with ranibizumab. 3.Intravitreal injection with ranibizumab combined with laserphotocoagulation for the treatment of macular edema caused by CRVO and median BCVA elevating is better than laserphotocoagulation only or intravitreal injection with ranibizumab only.